Students’ reflections on the introduction of virtual microscopy into general pathology training.
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Transcript of Students’ reflections on the introduction of virtual microscopy into general pathology training.
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Students’ reflections on the introduction of virtual microscopy into general pathology training.
Diana Jonas-Dwyer*, Fay Sudweeks, Philip K. Nicholls & Tanya McGill
*Medical Education (Managed Learning Systems) Education Centre, University of Western Australia
Year 1Basic Histology
Year 2Further Histology
Year 3General Pathology
Year 4Systemic pathology
Year 5Post-mortem & biopsy
clinical rotations
Veterinary
Chiropractic
Biomedical Sci.
Year 4Other units
Year 5Other units &
clinical practicum
Animal Science
Who learns histology & pathology?
Lectures (mixed cohorts, with cohort-specific lectures where applicable)
Resources: texts, internet
N=370
Teaching media
Powerpoint self-paced tutorials (delivered via WebCT)
Teaching media
Laboratory workshops
Teaching media
•Do some students find working a light microscope a technical barrier to learning?•Do all cohorts need to learn technical skills in light microscopy?•Do some students take only a passive role on the multiheader microscopes?•Limited time for private study and revision in the multiheader microscope suite•Can we make it better?
Our concerns
•Introduction of a virtual microscope in laboratory classes•Random allocation to either optical or virtual microscope group for labs •Complete ASSIST at the beginning of semester and again at the end.
Our study
• ASSIST – Entwistle’s Approaches and Study Skills Inventory
for students ASSIST (1998) to identify deep, surface and strategic learners
• Lectures, Labs, virtual microscope, blended environment (eLearning: images and questions)
• Gather both qualitative and quantitative data (Log book (lab time), eLearning tracking – use of resources (images and formative assessments).
• Longitudinal case study
Our study
Aperio slide scanning
Choose good examples from class slide set
RCPA QAP Pty Ltd Anatomical Pathology - VIC
wireless network
Implementation computer labs
n.b. pairs
Aperio screenshot
35%
30%18%
18%
8%
5%
5%
3%
3%
3%
Optical microscopy +ve
enhanced clarity
better group workpromotes group discussions
authenticity
familiarity
more teacher interaction
more sense of control
superior slide quality
gaining experience
nothing particular
• “The group atmosphere was probably the highlight of the optical microscopes”
• “… at higher magnification it was a lot clearer to view slides in comparison to virtual”
• “You get to see everything for real and you get experience using a microscope”
• “Can look at slide with naked eye view first, it made things seem very real, a computer cannot replicate that”
• “Give a realistic and relevant element to learning (i.e. its real tissue), Gets you to learn how to use a microscope and the problems you have with it. It not just another simulation”
Optical microscopy +ve
Optical microscopy -ve
health issues
difficult to use
not in control
time consuming
missing slides
needs experience
dislike everything
40%
35%
30%
15%
8%
5%
3%
• “They gave me constant headaches and sore eyes” • “In addition, using the microscope gave me motion
sickness when other people were operating it”• “Can be a bit complicated to operate because of all
the parameters that can be adjusted.”• “The time spent looking for slides that had not been
put back into the correct box”• “Sometimes you want to look at something a bit
longer or sketch something, but you don’t want to have to make the group wait”
Optical microscopy -ve
Likes Virtual Microscopes
65%
63%
23%
20%
15%
13%
10%
3%3%
Virtual microscopy +ve
easy to use
more examples
fewer health problems
more convenient
easier to work in groups
freedom & accessibililty
more examples of pathology
65%
63%
23%
20%
15%
13%
10%3%
3%
better time management
handy tools (photo,
measure, side by side, naked eye navigator,)
• “Ease of use, don't need to know how to use a microscope and since I'll never have to use one in my career that is ideal for me”
• “It is so much easier to use than optical. You can change the magnification quickly and easily. You can zoom into the exact area you want"
• “You can take photos of it and email to yourself (you can take it home virtually)”
• “...it was available on a variety of computers, which made it very accessible”
• “It would have been nice to access it from home”• “Probably the best part is that all the slides are there to use
there is no need to sort through hundreds of glass slides to find the one you need”
• “No headaches either”
Virtual microscopy +ve
Dislikes Virtual Microscopes
38%
13%13%
10%
5%
5%
5%
5%
38%
13%13%
10%
5%
5%
5%
5%
reduced clarity
waiting for slide upload
restricted access
no dislikes
less group work
unreliable technology
less engagement
less authentic
Virtual microscopy -ve
• “Images at higher magnifications are not as sharp and clear”
• “Would be better if you could access the slides from home”
• “Took too long to load up sometimes”
• “There was also less group discussion involved as each student has an individual program”
• “You feel more of a distance to what you are looking at when you can't "put hands" on it”
Virtual microscopy -ve
•Do some students find working a light microscope a technical barrier to learning?•Do all cohorts need to learn technical skills in light microscopy?•Do some students take only a passive role on the multiheader microscopes?•Limited time for private study and revision in the multiheader microscope suite•Can we make it better?
Our concerns
• Deliver via DVD as well as network (home study)• Encourage students to work in groups
– Description games– Alter laboratory layout for better group work– Assigning a slide to a group for annotation & presentation to
rest of class via data projector
• Alternate between virtual & optical groups• Use virtual slides for take home exam (description &
diagnosis)• Use annotation files to answer queries via online
learning systems (WebCT/CE6)• Align assessment with objectives and activities
(examine via structured image-based questions)
Improvements
• The work presented here forms part of the PhD programme of Diana Jonas-Dwyer, Medical Education (Managed Learning System) Education Centre, University of Western Australia.
Acknowledgements
5
63
0
0
63
32
0
0
31
6
0 20 40 60 80 100
1 Very Skilled
2
3
4
5, Little or No Skills
Sk
ill L
ev
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Percent
Group A, Optical Group B, Virtual
Students’ self-rating of IT skills
IT skills
4
H&E x100
Sheep heart x 10
• Slide 110A. Heart, left ventricle, sheep
• Bundle of Purkinje fibres within left ventricular myocardium
You should be able to compare and contrast features
of three muscle types.
One feature unique to cardiac muscle is seen here. What is
the feature shown?
what’s this?
Zoom in!
Note the pale and enlarged cytoplasm of these specialised cells.
What is the name, and function, of these cells, unique to myocardium?
Purkinje fibres – specialised for electrical
conduction.
You should be able to see cross striations in heart in LS, but don’t confuse them with
intercalated disks.
Zoom in!
striations
IC disk
IC disk
IC disk